Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03776 | Date 21/02/2019 |
| Token No | SM/18-19/10392 11/03/2019 | Serial | 101 Last Visit: 11/03/2019 |
| Patient Name | Mrs. KABERI CHAKRABORTY | Contact No | 9830200603 |
| Address | GANGADARSHAN FLAT ( RAJA K.L GOSWAMI STREET) | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||